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Thiotepa-Containing Conditioning Regimen for Allogeneic HSCT in Chronic Myelomonocytic Leukemia

11. september 2026 oppdatert av: Sun Yuqian, Peking University People's Hospital

Prospective Single-Arm Clinical Study of Thiotepa-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Chronic Myelomonocytic Leukemia

This is a prospective, single-arm clinical study. It aims to evaluate the effectiveness and safety of a conditioning regimen containing thiotepa (in combination with busulfan and fludarabine, with or without ATG) of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with chronic myelomonocytic leukemia (CMML) who have an intermediate-2 or high-risk prognosis.

The main goal is to evaluate 1 year RFS and OS. Other goals include assessing engraftment, overall survival, transplant-related complications, and side effects. A total of 31 participants will be enrolled.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

31

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

  • Kina
      • Beijing, Kina, 100044
        • Rekruttering
        • Peking University People's Hospital
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Age ≥ 18 years, any sex/gender.
  • Confirmed diagnosis of chronic myelomonocytic leukemia (CMML) according to the 2022 WHO classification.
  • Intermediate-2 or high-risk CMML based on CPSS or CPSS-mol score, and planned to receive allo-HSCT.
  • Has a suitable hematopoietic stem cell donor:
  • For haploidentical donor: at least 5/10 HLA match at HLA-A, -B, -C, -DQB1, and -DRB1.
  • For unrelated donor: at least 9/10 HLA match at the same five loci.
  • For matched sibling donor: 10/10 HLA match at the same five loci.
  • Hematopoietic cell transplantation comorbidity index (HCT-CI) ≤ 2, with generally good health and no significant organ abnormalities or major comorbidities.
  • Adequate organ function as defined below:
  • Left ventricular ejection fraction (LVEF) ≥ 50%, and no uncontrolled tachycardia or bradycardia-tachycardia syndrome.
  • Total bilirubin ≤ 1.5 × upper limit of normal (ULN); ALT ≤ 2 × ULN; AST ≤ 2 × ULN.
  • Serum creatinine ≤ 1.5 × ULN.
  • Baseline oxygen saturation > 92%.
  • Pulmonary function: DLCO (corrected for hemoglobin) ≥ 40%, FEV1 ≥ 50%.
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.
  • Agrees not to participate in any other interventional study during the treatment period.
  • Willing and able to provide written informed consent, understand the nature, purpose, and procedures of the study, and voluntarily comply with study requirements.

Exclusion Criteria:

  • Previous allogeneic HSCT for CMML that later relapsed.
  • Unwilling or unable to receive the study treatment regimen.
  • Active hepatitis B or C, or chronic active hepatitis; known human immunodeficiency virus (HIV) infection.
  • Active uncontrolled infection, including: hemodynamic instability related to infection, new or worsening signs/symptoms of infection, new infection lesions on imaging, or persistent fever without explanation despite no symptoms/signs.
  • History of stroke or intracranial hemorrhage within 6 months before enrollment.
  • Known pregnancy (positive urine pregnancy test), or currently breastfeeding.
  • Diagnosis of another malignancy within the past 2 years, except for localized skin cancer, superficial bladder cancer, carcinoma in situ of the cervix, breast cancer, or localized prostate cancer (Gleason score ≤ 6) that has been treated with curative intent.
  • Any other condition that, in the investigator's judgment, makes the patient unsuitable for study participation.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Single Arm: Thiotepa + Busulfan + Fludarabine ± ATG
Patients with intermediate-2 or high-risk chronic myelomonocytic leukemia (CMML) per CPSS/CPSS-mol criteria, who are scheduled to receive allogeneic hematopoietic stem cell transplantation (allo-HSCT) with a thiotepa-containing conditioning regimen.
Legemiddel: TBF regimen
Intravenous thiotepa 5 mg/kg/d on days -11,-10; busulfan 3.2 mg/kg/d on days -8,-7,-6; fludarabine 30 mg/m²/d on days -6 to -2; ATG per donor type (haplo/unrelated: 2.5 mg/kg/d days -5 to -2; MSD: 1.125 mg/kg/d days -5 to -2). Allogeneic stem cells infused on day 0. GVHD prophylaxis: CsA, MMF, MTX per protocol.
Andre navn:
  • TBF (Thiotepa, Busulfan, Fludarabine) ± ATG

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
One-year relapse-free survival (RFS) after allogeneic hematopoietic stem cell transplantation
Tidsramme: At 12 months after allogeneic hematopoietic stem cell transplantation.
Time from stem cell infusion to hematologic/extramedullary relapse or death, censored at 12 months for event-free participants.
At 12 months after allogeneic hematopoietic stem cell transplantation.

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
One-year overall survival (OS)
Tidsramme: At 12 months after allogeneic hematopoietic stem cell transplantation.
Overall survival is defined as the time from stem cell infusion to death from any cause. Participants alive at 12 months are censored at the last follow-up.
At 12 months after allogeneic hematopoietic stem cell transplantation.
One-year cumulative incidence of relapse (RR)
Tidsramme: At 12 months after allogeneic hematopoietic stem cell transplantation.
Relapse is defined as recurrence of CMML . Non-relapse mortality is treated as a competing risk.
At 12 months after allogeneic hematopoietic stem cell transplantation.
One-year non-relapse mortality (NRM)
Tidsramme: At 12 months after allogeneic hematopoietic stem cell transplantation.
Non-relapse mortality is defined as death from any cause other than disease relapse or progression. Relapse is treated as a competing risk.
At 12 months after allogeneic hematopoietic stem cell transplantation.
Regimen toxicity at day +30
Tidsramme: Up to day +30 post-transplant
Toxicity is graded according to NCI CTCAE v5.0. Any grade 3-5 non-hematologic toxicity occurring within 30 days after stem cell infusion is reported.
Up to day +30 post-transplant
Incidence and severity of adverse events (AEs)
Tidsramme: At 12 months after allogeneic hematopoietic stem cell transplantation.
AEs are coded using MedDRA and graded per NCI CTCAE v5.0. All AEs, serious AEs (SAEs), and AEs leading to treatment discontinuation are summarized.
At 12 months after allogeneic hematopoietic stem cell transplantation.
Incidence and severity of acute graft-versus-host disease (aGVHD)
Tidsramme: Up to day +100 post-transplant
Acute GVHD is diagnosed and graded according to the modified Glucksberg criteria or MAGIC criteria. Both overall incidence and grade II-IV/III-IV severity are reported.
Up to day +100 post-transplant
Incidence and severity of chronic graft-versus-host disease (cGVHD)
Tidsramme: From day +100 up to 1 year post-transplant
Chronic GVHD is diagnosed and graded according to the NIH consensus criteria (mild, moderate, severe). Overall incidence and severity distribution are reported.
From day +100 up to 1 year post-transplant

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Peking University People's Hospital

Samarbeidspartnere

Jiangsu Hengrui Pharmaceutical Co., Ltd.

Etterforskere

  • Hovedetterforsker: Yuqian Sun, MD, Peking University People's Hospital

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

13. februar 2026

Primær fullføring (Antatt)

1. mai 2028

Studiet fullført (Antatt)

1. mai 2028

Datoer for studieregistrering

Først innsendt

6. mai 2026

Først innsendt som oppfylte QC-kriteriene

6. mai 2026

Først lagt ut (Faktiske)

15. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

15. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

11. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 2025PHD048-001

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

Individual participant data will not be shared with other researchers.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

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